Consumer Real-Time Pharmacy Benefit Check FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-rtpbc/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "rtpbc-bundle-request-03-price-source",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle"
]
},
"type" : "message",
"timestamp" : "2019-11-15T13:10:13-05:00",
"entry" : [
{
"fullUrl" : "http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-03",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "rtpbc-messageheader-request-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-request-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-03</b></p><a name=\"rtpbc-messageheader-request-03\"> </a><a name=\"hcrtpbc-messageheader-request-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-messageheader.html\">RTPBC Request MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-request\">RTPBC Event Type Code System rtpbc-request</a>: RTPBC Request</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>MyPatientApp</td><td><a href=\"http://example.org/MyPatientApp\">http://example.org/MyPatientApp</a></td></tr></table><p><b>focus</b>: <a href=\"Claim-rtpbc-claim-03.html\">Claim: identifier = rtpbc-03; status = active; type = Pharmacy; use = predetermination; created = 2019-11-01 11:20:54-0500; priority = Normal</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-request.html\">RTPBC Request Message Definition</a></p></div>"
},
"eventCoding" : {
"system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
"code" : "rtpbc-request",
"display" : "RTPBC Request"
},
"source" : {
"name" : "MyPatientApp",
"endpoint" : "http://example.org/MyPatientApp"
},
"focus" : [
{
🔗 "reference" : "Claim/rtpbc-claim-03"
}
],
"definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"
}
},
{
"fullUrl" : "http://example.org/my-app/Claim/rtpbc-claim-03",
"resource" : {
"resourceType" : "Claim",
"id" : "rtpbc-claim-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_rtpbc-claim-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-03</b></p><a name=\"rtpbc-claim-03\"> </a><a name=\"hcrtpbc-claim-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-claim.html\">RTPBC Request Using Claim</a></p></div><p><b>identifier</b>: rtpbc-03</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}\">Pharmacy</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href=\"Patient-rtpbc-patient-03.html\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier:\u00a030455)</a></p><p><b>created</b>: 2019-11-01 11:20:54-0500</p><p><b>provider</b>: <a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>prescription</b>: <a href=\"MedicationRequest-rtpbc-medicationrequest-03.html\">MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = PROzac 10 MG Oral Capsule; authoredOn = 2019-11-01</a></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Practitioner-rtpbc-practitioner-03.html\">Practitioner Johnson </a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>Identifier: GOODPRICING</td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1</td><td><span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">PROzac 10 MG Oral Capsule</span></td><td>60 {Each}</td></tr></table></div>"
},
"identifier" : [
{
"value" : "rtpbc-03"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "pharmacy",
"display" : "Pharmacy"
}
]
},
"use" : "predetermination",
"patient" : {
🔗 "reference" : "Patient/rtpbc-patient-03"
},
"created" : "2019-11-01T11:20:54-05:00",
"provider" : {
🔗 "reference" : "Organization/rtpbc-organization-03"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal",
"display" : "Normal"
}
]
},
"prescription" : {
🔗 "reference" : "MedicationRequest/rtpbc-medicationrequest-03"
},
"careTeam" : [
{
"sequence" : 1,
"provider" : {
🔗 "reference" : "Practitioner/rtpbc-practitioner-03"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"identifier" : {
"value" : "GOODPRICING"
}
}
}
],
"item" : [
{
"sequence" : 1,
"careTeamSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "205535",
"display" : "PROzac 10 MG Oral Capsule"
}
]
},
"quantity" : {
"value" : 60,
"unit" : "{Each}"
}
}
]
}
},
{
"fullUrl" : "http://example.org/my-app/Patient/rtpbc-patient-03",
"resource" : {
"resourceType" : "Patient",
"id" : "rtpbc-patient-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_rtpbc-patient-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient rtpbc-patient-03</b></p><a name=\"rtpbc-patient-03\"> </a><a name=\"hcrtpbc-patient-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-patient.html\">RTPBC Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier:\u00a030455)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">100 Oak Court Madison WI 53510 US </td></tr></table></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PI",
"display" : "Patient internal identifier"
}
],
"text" : "Patient internal identifier"
},
"system" : "http://example.org/MyPatientApp",
"value" : "30455"
}
],
"name" : [
{
"family" : "Doe",
"given" : [
"Jane"
]
}
],
"gender" : "female",
"birthDate" : "1975-12-05",
"address" : [
{
"line" : [
"100 Oak Court"
],
"city" : "Madison",
"state" : "WI",
"postalCode" : "53510",
"country" : "US"
}
]
}
},
{
"fullUrl" : "http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-03",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "rtpbc-medicationrequest-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_rtpbc-medicationrequest-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest rtpbc-medicationrequest-03</b></p><a name=\"rtpbc-medicationrequest-03\"> </a><a name=\"hcrtpbc-medicationrequest-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-medicationrequest.html\">RTPBC Medication Request</a></p></div><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>reported</b>: true</p><p><b>medication</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">PROzac 10 MG Oral Capsule</span></p><p><b>subject</b>: <a href=\"Patient-rtpbc-patient-03.html\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier:\u00a030455)</a></p><p><b>authoredOn</b>: 2019-11-01</p><p><b>requester</b>: <a href=\"Practitioner-rtpbc-practitioner-03.html\">Practitioner Johnson </a></p><h3>DosageInstructions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>Take 2 capsules once a day</td></tr></table><blockquote><p><b>dispenseRequest</b></p><p><b>quantity</b>: 60 {Each}</p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>30</td><td>days</td><td><a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ucum.html\">http://unitsofmeasure.org</a></td><td>d</td></tr></table><p><b>performer</b>: <a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></p></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Allowed[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>false</td></tr></table></div>"
},
"status" : "draft",
"intent" : "proposal",
"reportedBoolean" : true,
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "205535",
"display" : "PROzac 10 MG Oral Capsule"
}
]
},
"subject" : {
🔗 "reference" : "Patient/rtpbc-patient-03"
},
"authoredOn" : "2019-11-01",
"requester" : {
🔗 "reference" : "Practitioner/rtpbc-practitioner-03"
},
"dosageInstruction" : [
{
"text" : "Take 2 capsules once a day"
}
],
"dispenseRequest" : {
"quantity" : {
"value" : 60,
"unit" : "{Each}"
},
"expectedSupplyDuration" : {
"value" : 30,
"unit" : "days",
"system" : "http://unitsofmeasure.org",
"code" : "d"
},
"performer" : {
🔗 "reference" : "Organization/rtpbc-organization-03"
}
},
"substitution" : {
"allowedBoolean" : false
}
}
},
{
"fullUrl" : "http://example.org/my-app/Practitioner/rtpbc-practitioner-03",
"resource" : {
"resourceType" : "Practitioner",
"id" : "rtpbc-practitioner-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_rtpbc-practitioner-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner rtpbc-practitioner-03</b></p><a name=\"rtpbc-practitioner-03\"> </a><a name=\"hcrtpbc-practitioner-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</p><p><b>name</b>: Johnson </p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567890"
}
],
"name" : [
{
"family" : "Johnson"
}
]
}
},
{
"fullUrl" : "http://example.org/my-app/Organization/rtpbc-organization-03",
"resource" : {
"resourceType" : "Organization",
"id" : "rtpbc-organization-03",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_rtpbc-organization-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization rtpbc-organization-03</b></p><a name=\"rtpbc-organization-03\"> </a><a name=\"hcrtpbc-organization-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-pharmacy-organization.html\">RTPBC Pharmacy Organization</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/6.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9876543210</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType R}\">Retail</span></p><p><b>name</b>: Hometown Drug</p><p><b>telecom</b>: ph: 6081234567</p><p><b>address</b>: 900 9th Street Madison WI 53535 US </p></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9876543210"
}
],
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType",
"code" : "R",
"display" : "Retail"
}
]
}
],
"name" : "Hometown Drug",
"telecom" : [
{
"system" : "phone",
"value" : "6081234567"
}
],
"address" : [
{
"line" : [
"900 9th Street"
],
"city" : "Madison",
"state" : "WI",
"postalCode" : "53535",
"country" : "US"
}
]
}
}
]
}